Individual
CARISSA VAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
460 QUINCY AVE, QUINCY, MA 02169-8130
(800) 852-2844
(617) 786-9894
Mailing address
24 PEACH ST, BRAINTREE, MA 02184-8112
(781) 664-3500
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/11/2017
Last updated
07/11/2017
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